Trends in U.S. Ambulatory Cardiovascular Care 2013 to 2017: JACC Review Topic of the Week

Thomas M. Maddox, Yang Song, Joseph Allen, Paul S. Chan, Adeela Khan, Jane J. Lee, Joshua Mitchell, William J. Oetgen, Angelo Ponirakis, Claire Segawa, John A. Spertus, Fran Thorpe, Salim S. Virani, Frederick A. Masoudi

Research output: Contribution to journalReview articlepeer-review

25 Citations (Scopus)


The National Cardiovascular Data Registry PINNACLE (Practice Innovation and Clinical Excellence) Registry is the largest outpatient cardiovascular practice registry in the world. It tracks real-world management and quality of 4 common cardiovascular conditions: heart failure, coronary artery disease, atrial fibrillation, and hypertension. In 2013, the PINNACLE Registry contained information on 2,898,505 patients, cared for by 4,859 providers in 431 practices. By 2017, the registry contained information on 6,040,996 patients, cared for by 8,853 providers in 724 practices. During this time period, care processes for PINNACLE patients generally improved. Among patients with heart failure, combined beta-blocker and renin-angiotensin antagonist medication rates increased from 60.7% to 72.8%. Among patients with coronary artery disease, statin medication rates increased from 66% to 80.1%. Among patients with atrial fibrillation, oral anticoagulation rates increased from 52.7% to 65.2%. In contrast, blood pressure control rates among patients with hypertension were largely stable. PINNACLE data also fueled a variety of quality measurement programs and 51 peer-reviewed publications.

Original languageEnglish
Pages (from-to)93-112
Number of pages20
JournalJournal of the American College of Cardiology
Issue number1
Publication statusPublished - 7 Jan 2020
Externally publishedYes


  • ambulatory cardiac care
  • health services research
  • quality of care
  • real-world data
  • registries


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